The action of Ambien is similar to that of benzodiazepines. The drug has a hypnotic, amnesic, anti-seizure, anxiolytic and sedative effect.
The drug improves the sleep quality, helps you fall asleep faster and normalizes the sleep process. As a rule, patients don’t feel drowsy after waking up.
Depending on the rate of absorption, the peak concentration of the active substance in blood is reached within 30-180 minutes after the intake. Ambien almost completely binds to plasma proteins. The bioavailability of the drug is about 70 %.
The drug is metabolized in the liver tissue, forming 3 inactive metabolites. Half of them are excreted in the urine, and about 40%- in feces. The half-life of the drug is 150 minutes. If the patient has severe liver problems, this process may take up to 10 hours.
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The drug can pass into breast milk.
Way of administration and dosage
The pills should be taken before sleep. The standard dose is 10 mg.
Initial dose for elderly patients is 5 mg (if necessary, it can be increased to 10 mg).vv
Maximum daily dosage of Zolpidem is 10 mg.
The drug shouldn’t be taken for more than one month.
Patients with transient insomnia should take the drug for 2-5 days, while those with situational insomnia need to use it for 14-21 days.
If the treatment has lasted only a few days, the drug can be withdrawn abruptly. However, if you have used Ambien for more than a week, you should gradually reduce the dose to avoid undesirable reactions.
The drug is not prescribed in the following cases:
• severe or acute respiratory failure;
• sleep apnea;
• pregnancy and breastfeeding;
• allergy to Ambien or other benzodiazepines;
• minor age;
• severe kidney and liver diseases;
• lactose intolerance.
Patients suffering from depression, drug addicts, alcoholics and patients suffering from other types of addiction should be especially careful when taking the drug.
Most often, the drug doesn’t cause undesirable effects.
However, some patients may develop:
• drowsiness, headache, paradoxical insomnia, agitation and nightmares;
• sickness, diarrhea, vomiting and stomachache;
• anterograde amnesia (the risk of which is directly proportional to the dosage) and vertigo.
Less frequent side effects are:
• irritability, dysphoria, unusual behavior and drug addiction;
• liver disorders, elevated liver enzymes and muscle weakness;
• confusion, aggression and somnambulism;
• skin rash, urticaria, itching, hyperhidrosis and Quincke’s edema;
• low libido, ataxia, drug addiction and diplopia.
Abuse of Ambien (or accidental swallowing of a large number of pills) can cause ataxia, confusion, hypotension, difficulty breathing, lethargy and coma.
In case of overdose, it is recommended to induce vomiting and give the patient enterosorbents (activated carbon) as soon as possible (preferably within 60 minutes after the drug intake). If the patient is unconscious, it is necessary to get his/her stomach pumped and carry out a symptomatic treatment.
Flumazenil is a specific antidote. Dialysis is ineffective. The use of flumazenil increases the risk of seizures, especially in patients with epilepsy.
The long-term treatment (over 20-30 days) can cause physical or mental dependence on Ambien. Patients with a history of drug and alcohol addiction are especially susceptible to this reaction. This group of patients must be supervised, periodically monitoring their physical and mental condition.
The combination of Ambien with other benzodiazepines increases the risk of addiction. Keep in mind that the patient must sleep for 7-8 hours after the drug intake. Otherwise, it can lead to anterograde amnesia.